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IBH

Innovation in Behavioral Health Model

The Innovation in Behavioral Health (IBH) Model is a state-based model that leverages patients' relationships with specialty behavioral health practices to provide whole-person, integrated care. It aligns Medicaid and Medicare to better address behavioral, mental, and physical health for adults with moderate to severe mental health conditions or substance use disorders.

Active since 2025-01-01Application deadline 2026-06-03

Innovation

Aligns Medicaid and Medicare value-based payments for specialty behavioral health practices, offering a 'no wrong door' approach and integrating physical health screenings, care management, and upstream drivers of health into behavioral health settings.

The Problem

Medicare and Medicaid populations face disproportionately high rates of mental health conditions, substance use disorders (SUD), or both. As a result, they are more likely to experience poor health outcomes, such as frequent visits to the emergency department, hospitalizations, and even premature death.

The Solution

The IBH Model offers a “no wrong door” approach to delivering care and promoting prevention, enabling specialty behavioral health providers to serve as a point of entry to identify an individual’s range of needs, secure further care, and facilitate close collaboration with primary and specialty care providers.

Expected Outcomes

People receiving care through the IBH Model will have a more integrated, person-centered experience that focuses on all aspects of their health and will help them to stay healthier longer, with fewer hospital visits and improved physical and behavioral health outcomes.

Strategy

The IBH Model supports the Innovation Center’s core pillar of promoting evidence-based prevention by incorporating screening, early intervention, care coordination, and identification of upstream drivers of health into provider workflows.

Model Goals

  • Improve quality of care
  • Increase access to care
  • Improve priority health conditions (diabetes, hypertension, tobacco use disorder)
  • Reduce avoidable emergency department and inpatient utilization

Patient Eligibility

Adult Medicaid and Medicare beneficiaries with moderate to severe behavioral health conditions receiving care from an eligible Practice Participant.

  • 18 years of age and older
  • Has moderate to severe mental health conditions, a SUD, or both
  • Receiving outpatient care from an eligible Practice Participant
  • Needs meet the level of care required by the IBH Model's care delivery framework

Provider Eligibility

Specialty behavioral health practices that predominantly provide outpatient behavioral health treatment services to adult Medicaid beneficiaries.

  • Have at least one state-licensed behavioral health provider eligible for Medicaid reimbursement
  • Serve adult Medicaid beneficiaries (age 18 or older) with moderate to severe behavioral health conditions
  • Provide mental health and/or SUD treatment services at the outpatient level of care (excluding intensive outpatient)
  • Serve, on average, at least 25 Medicaid beneficiaries per month who meet the threshold for moderate to severe behavioral health conditions
  • Must participate in their state's Medicaid program

Care Categories

Behavioral Health

Mental Health ConditionsSubstance Use Disorders (SUD)

Physical Health Integration

DiabetesHypertensionTobacco Use Disorder

CMS Benchmarks & Thresholds

eligibility

Beneficiary Minimum Age18

financial

State Cooperative Agreement Funding$7,500,000
Model Year 4 ISP Bonus0.04%
Model Year 5-7 ISP Bonus0.05%
Model Year 6 ISP Withhold0.02%
Medicaid-Only Practice Infrastructure Funding$100,000
Medicare/Medicaid Practice Additional Infrastructure Funding$200,000
Model Year 4 Performance Payment Weight for Acute Hospital/ED Utilization0.1%
Model Year 4 Performance Payment Weight for Other Measures0.2%
Average Spend per Beneficiary200 – 220
Model Year 3 ISP Bonus0.03%
Model Year 7 ISP Withhold0.05%

operational

Typical Implementation Timeline60
Model Duration8
Cohort 1 Implementation Duration5
Cohort 2 Pre-Implementation Duration2
Cohort 2 Implementation Duration5
Cohort 2 Application Deadline Year2,026
Cohort 2 Letter of Intent Deadline Year2,026
Cohort 1 Pre-Implementation Duration3

population

Maximum Additional States for Cohort II5
Typical Beneficiary Count25
Current State Participants Count3

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